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Hole in the fovea!

⁣⁣⁣⁣⁣𝘍𝘶𝘭𝘭 𝘵𝘩𝘪𝘤𝘬𝘯𝘦𝘴𝘴 𝘔𝘢𝘤𝘶𝘭𝘢𝘳 𝘏𝘰𝘭𝘦⁣⁣⁣⁣⁣⁣ ● Round retinal break involving all the layers of the retina at the fovea⁣⁣, more common in females⁣⁣⁣⁣⁣⁣ ⁣⁣⁣⁣⁣⁣ 𝘊𝘢𝘶𝘴𝘦𝘴:⁣⁣⁣⁣⁣⁣ ● Idiopathic⁣⁣⁣⁣⁣⁣ ● Pathological Myopia⁣⁣⁣⁣⁣⁣ ● Blunt ocular trauma⁣⁣⁣⁣⁣⁣ ● Ocular inflammation⁣⁣⁣⁣⁣⁣ ● Cystoid macular edema⁣ etc⁣⁣⁣⁣⁣ ⁣⁣⁣⁣⁣⁣ 𝘊𝘭𝘪𝘯𝘪𝘤𝘢𝘭 𝘧𝘦𝘢𝘵𝘶𝘳𝘦𝘴:⁣⁣⁣⁣⁣⁣ Loss of central visual acuity, metamorphosia, micropsia⁣⁣⁣⁣⁣⁣

⁣⁣⁣⁣⁣⁣ 𝘗𝘢𝘵𝘩𝘰𝘨𝘦𝘯𝘦𝘴𝘪𝘴:⁣⁣⁣⁣⁣⁣ Tangential and anteroposterior traction of the posterior hyaloid on the parafovea⁣⁣⁣⁣⁣⁣ ⁣⁣⁣⁣⁣⁣ 𝘎𝘢𝘴𝘴 𝘚𝘵𝘢𝘨𝘪𝘯𝘨: ⁣⁣⁣⁣⁣⁣⁣⁣ ⁣⁣Stage 1a : Impending macular hole (Vitreomacular Traction) : Yellow spot⁣⁣⁣⁣⁣⁣ ⁣Stage 1b : Occult macular hole (VMT) : Yellow ring⁣⁣⁣⁣⁣⁣ ⁣⁣⁣⁣Stage 2 : Small FTMH < 400 microns in diameter. Persistent vitreofoveolar adhesion.⁣⁣⁣⁣⁣⁣ ⁣⁣⁣⁣Stage 3 : Full thickness hole > 400 microns with a red base in which yellow white dots are seen. Surrounding grey cuff of subretinal fluid seen. Overlying retinal operculum.⁣⁣⁣⁣⁣⁣ ⁣⁣⁣⁣Stage 4 : Full size macular hole with complete PVD. The posterior vitreous is completely detached, often suggested by the presence of a Weiss ring.⁣⁣⁣⁣⁣⁣

⁣⁣⁣⁣⁣⁣ 𝘋𝘪𝘢𝘨𝘯𝘰𝘴𝘪𝘴 𝘢𝘯𝘥 𝘐𝘯𝘷𝘦𝘴𝘵𝘪𝘨𝘢𝘵𝘪𝘰𝘯𝘴:⁣⁣⁣⁣⁣⁣ ● Clinical examination through slit lamp biomicroscopy/ indirect ophthalmoscopy.⁣⁣⁣⁣⁣⁣ ● Amsler Grid⁣⁣⁣⁣⁣⁣ ● 𝘞𝘢𝘵𝘻𝘬𝘦- 𝘈𝘭𝘭𝘦𝘯 𝘛𝘦𝘴𝘵⁣⁣⁣⁣⁣⁣ - Narrow vertical slit beam over the fovea with a 90/78D - Break in the bar of light indicates presence of FTMH⁣⁣⁣⁣⁣⁣ ● 𝘓𝘢𝘴𝘦𝘳 𝘢𝘪𝘮𝘪𝘯𝘨 𝘣𝘦𝘢𝘮 𝘛𝘦𝘴𝘵⁣⁣⁣⁣⁣⁣ - 50 micron laser beam within lesion- patients with FTMH cannot detect it within⁣⁣⁣⁣⁣⁣ the lesion but can detect it when placed in the surroundings⁣⁣⁣⁣⁣⁣ ● 𝘖𝘱𝘵𝘪𝘤𝘢𝘭 𝘊𝘰𝘩𝘦𝘳𝘦𝘯𝘤𝘦 𝘛𝘰𝘮𝘰𝘨𝘳𝘢𝘱𝘩𝘺⁣⁣⁣⁣⁣⁣ For diagnosis and staging, prognosis⁣⁣⁣⁣⁣⁣ ● FFA⁣⁣⁣⁣ - Early hyperfluorescence (window defect)⁣⁣⁣⁣⁣⁣ ⁣⁣⁣⁣⁣⁣ 𝘔𝘢𝘯𝘢𝘨𝘦𝘮𝘦𝘯𝘵:⁣⁣⁣⁣⁣⁣ ● Observation (50% of stage 1 holes resolve spontaneously)⁣⁣⁣⁣⁣⁣ ● Pharmacological vitreolysis with ocriplasmin⁣⁣⁣⁣⁣⁣ ● Surgery – PPV with ILM peeling and gas⁣⁣⁣ tamponade⁣⁣⁣⁣⁣⁣ ⁣⁣⁣⁣⁣⁣⁣⁣⁣⁣⁣⁣ ⁣⁣⁣⁣⁣⁣ Image from Rajan Eye Care Hospital #ophthalmology #ophthal #doctor #health #medical #vision #education #optometry #medicalstudent #optometrist #medicine #eye #ophtho #ophthalmologist #ophthalmo #med #medicaleducation #ophthalmologyresident #ophthalmologyresidency #macula #macularhole #fullthicknessmacularhole #retina #trauma #opticalcoherencetomography

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